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General NPI Number Information
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NPI Number | 1457648438
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Entity Type | Organization
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Legal Business Name | A NEW BEGINNING BEHAVIORAL SERVICES, INC
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Dates
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Enumeration Date | 06/29/2011
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Last Update Date | 06/29/2011
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Provider Practice Location Address
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Address Line | 3900 NW 79TH AVE SUITE 501
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City | DORAL
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State | FL
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Zip | 33166-6556
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Country | US
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Telephone | 305-597-3861
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Fax | 305-597-3863
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Provider Business Mailing Address
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Address Line | 3900 NW 79TH AVE SUITE 501
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City | DORAL
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State | FL
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Zip | 33166-6556
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Country | US
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Telephone | 305-597-3861
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Fax | 305-597-3863
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | CARY BOUZA-MERIDA
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Credential |
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Telephone | 305-597-3861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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